Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

La donazione del cordone ombelicale: l’esperienza della clinica ostetrico-ginecologica di Udine dal 2002 al 2006

Il sangue del cordone ombelicale costituisce una ricca fonte di cellule staminali emopoietiche e mesenchimali multipotenti e viene impiegato nel trattamento di numerose patologie. Lo scopo di questo studio è stato quello di valutare il lavoro svolto nella nostra Clinica nel reclutamento e nella selezione delle madri donatrici, nel periodo compreso tra gennaio 2002 e dicembre 2006 e analizzare l’esito delle donazioni di sangue cordonale. Sulla base di criteri forniti dalla Banca del Sangue di Cordone di Padova, alla quale il nostro centro fa riferimento, sono state escluse dalla donazione pazienti e coppie con familiarità per alcune patologie di rilievo. Dal 2002 al 2006 sono stati condotti 1.851 colloqui ed il numero totale di sacche idonee ed attualmente depositate presso la Banca del Sangue di Cordone di Padova con il sangue del cordone ombelicale di mamme che hanno partorito presso la nostra clinica sono 96 (6.1%)

Primary hyperparathyroidism in pregnancy

Objective: To determine the management of a patient with primary hyperparathyroidism and the obstetric and neonatologic outcome. Design: Case report. Setting: University hospital of Udine, Italy. Patient(s): A 32-year-old black pregnant woman with primary hyperparathyroidism. Intervention(s): Hospitalization with observation, nuclear magnetic resonance of the neck, and right parathyroidectomy of the patient in the 15th week of gestation (WG). Monitoring during pregnancy until the delivery. Main Outcome Measure(s): Intrauterine pregnancy preservation and maternal and fetal morbidity and mortality. Result(s): After surgery, laboratory and clinical findings remained constant. The fetus' well-being until the delivery was performed with cardiotocography (CTG) and echographic monitoring. Symmetric intrauterine growth restriction was discovered at 37 WG. Cesarean section was performed at 38 +/- 2 WG owing to the CTG trace. Conclusion(s): Nuclear magnetic resonance of the neck in this case was the determining diagnostic exam. Parathyroidectomy, during the second trimester, is the therapeutic gold standard, especially in cases of severe hypercalcemia (>12 mg/dL)

Exploratory analysis of predictors of patient adherence to subcutaneous interferon beta-1a in multiple sclerosis: TRACER study

ABSTRACT: Objective: The TRACER multicenter retrospective study aimed to collect data on treatment adherence in a real-life setting, in order to identify predictors of adherence at baseline. Methods: We recruited 384 relapsing-remitting (RR) multiple sclerosis patients with at least 12 months of use of RebiSmart®. This electronic device records the performed injections and assesses adherence as the percentage of ‘not missing doses’, through the connection to the iMed database. Subjects with at least 80% of completed doses at the 12 month of therapy were defined ‘treatment adherents’. Results: After 12 months, 89.3% of patients were adherent; 93.2% of patients aged 26–40 years at baseline were adherent (vs 79% of the ≤25 and 87.5% of the ≥41 year olds; p = 0.006). Furthermore, 90.5% of patients with a baseline Expanded Disability Status Scale (EDSS) score <4 showed ≥80% adherence (vs 71.4% in those with EDSS score ≥4; p = 0.016). Fifty-four percent of the patients who were not adherent after 3 months were also not adherent after 12 months (OR 16.8; CI 95%:7.1–39.8). Conclusions: Patients aged 26–40 years and with an EDSS score <4 at baseline were the most adherent. The status of ‘treatment adherent’ in the first 3 months was predictive of higher adherence in the long term